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放射肿瘤学中共同决策与患者决策辅助工具的综述

A Review of Shared Decision-Making and Patient Decision Aids in Radiation Oncology.

作者信息

Woodhouse Kristina Demas, Tremont Katie, Vachani Anil, Schapira Marilyn M, Vapiwala Neha, Simone Charles B, Berman Abigail T

机构信息

Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Blvd, TRC 2 West, Philadelphia, PA, 19104, USA.

Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

出版信息

J Cancer Educ. 2017 Jun;32(2):238-245. doi: 10.1007/s13187-017-1169-8.

Abstract

Cancer treatment decisions are complex and may be challenging for patients, as multiple treatment options can often be reasonably considered. As a result, decisional support tools have been developed to assist patients in the decision-making process. A commonly used intervention to facilitate shared decision-making is a decision aid, which provides evidence-based outcomes information and guides patients towards choosing the treatment option that best aligns with their preferences and values. To ensure high quality, systematic frameworks and standards have been proposed for the development of an optimal aid for decision making. Studies have examined the impact of these tools on facilitating treatment decisions and improving decision-related outcomes. In radiation oncology, randomized controlled trials have demonstrated that decision aids have the potential to improve patient outcomes, including increased knowledge about treatment options and decreased decisional conflict with decision-making. This article provides an overview of the shared-decision making process and summarizes the development, validation, and implementation of decision aids as patient educational tools in radiation oncology. Finally, this article reviews the findings from decision aid studies in radiation oncology and offers various strategies to effectively implement shared decision-making into clinical practice.

摘要

癌症治疗决策复杂,对患者而言可能具有挑战性,因为通常有多种治疗方案可供合理考虑。因此,已开发出决策支持工具来协助患者进行决策过程。一种常用的促进共同决策的干预措施是决策辅助工具,它提供基于证据的结果信息,并引导患者选择最符合其偏好和价值观的治疗方案。为确保高质量,已提出用于开发最佳决策辅助工具的系统框架和标准。研究已考察了这些工具在促进治疗决策和改善决策相关结果方面的影响。在放射肿瘤学中,随机对照试验表明决策辅助工具有改善患者预后的潜力,包括增加对治疗方案的了解以及减少决策冲突。本文概述了共同决策过程,并总结了决策辅助工具作为放射肿瘤学中患者教育工具的开发、验证和实施情况。最后,本文回顾了放射肿瘤学中决策辅助工具研究的结果,并提供了各种策略,以有效地将共同决策应用于临床实践。

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